Molecular Characterization of Carbapenem Resistant Klebsiella pneumoniae in Malaysia Hospital

• Published in: Pathogens (Basel) 2021-03, Vol.10 (3), p.279
• Main Authors: Lau, Min Yi, Teng, Fui Enn, Chua, Kek Heng, Ponnampalavanar, Sasheela, Chong, Chun Wie, Abdul Jabar, Kartini, Teh, Cindy Shuan Ju
• Format: Article
• Language: English
• Subjects: carbapenem-resistant Klebsiella pneumoniae; carbapenemase; Enterobacteriaceae; NDM; OXA-48; PFGE
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens10030279

The emergence of carbapenem-resistant (CRKP) is a great concern, as carbapenems are the last-line therapy for multidrug-resistant Gram-negative bacteria infections. This study aims to report the epidemiology of CRKP in a teaching hospital in Malaysia based on the molecular genotypic and clinical characteristics of the isolates. Sixty-three CRKP strains were isolated from a tertiary teaching hospital from January 2016 until August 2017. Carbapenemase genes were detected in 55 isolates, with (63.5%) as the predominant carbapenemase gene, followed by (36.5%). At least one porin loss was detected in nine isolates. Overall, 63 isolates were divided into 30 clusters at similarity of 80% with PFGE analysis. Statistical analysis showed that in-hospital mortality was significantly associated with the usage of central venous catheter, infection or colonization by CRKP, particularly NDM-producers. In comparison, survival analysis using Cox proportional hazards regression identified a higher hazard ratio for patients with a stoma and patients treated with imipenem but a lower hazard ratio for patients with NDM-producing CRKP. OXA-48 carbapenemase gene was the predominant carbapenemase gene in this study. As CRKP infection could lead to a high rate of in-hospital mortality, early detection of the isolates was important to reduce their dissemination.